Over the past few years, MIT engineers have successfully tested robotic devices to help stroke patients learn to control their arms and legs. Now, they're building on that work to help children with cerebral palsy.
"Robotic therapy can potentially help reduce impairment and facilitate neuro-development of youngsters with cerebral palsy," says Hermano Igo Krebs, principal research scientist in mechanical engineering and one of the project's leaders.
Krebs and others at MIT, including professor of mechanical engineering Neville Hogan, pioneered the use of robotic therapy in the late 1980s, and since then the field has taken off.
"We started with stroke because it's the biggest elephant in the room, and then started to build it out to other areas, including cerebral palsy as well as multiple sclerosis, Parkinson's disease and spinal cord injury," says Krebs.
The team's suite of robots for shoulder-and-elbow, wrist, hand and ankle has been in clinical trials for more than 15 years with more than 400 stroke patients. The Department of Veterans Affairs has just completed a large-scale, randomized, multi-site clinical study with these devices.
All the devices are based on the same principle: that it is possible to help rebuild brain connections using robotic devices that gently guide the limb as a patient tries to make a specific movement.
When the researchers first decided to apply their work to children with cerebral palsy, Krebs was optimistic that it would succeed, because children's developing brains are more plastic than adults', meaning they are more able to establish new connections.
The MIT team is focusing on improving cerebral palsy patients' ability to reach for and grasp objects. Patients handshake with the robot via a handle, which is connected to a computer monitor that displays tasks similar to those of simple video games.
In a typical task, the youngster attempts to move the robot handle toward a moving or stationary target shown on the computer monitor. If the child starts moving in the wrong direction or does not move, the robotic arm gently nudges the child's arm in the right direction.
Krebs began working in robotic therapy as a graduate student at MIT almost 20 years ago. In his early studies, he and his colleagues found that it's important for stroke patients to make a conscious effort during physical therapy. When signals from the brain are paired with assisted movement from the robot, it helps the brain form new connections that help it relearn to move the limb on its own.
Even though a stroke kills many neurons, "the remaining neurons can very quickly establish new synapses or reinforce dormant synapses," says Krebs.
For this type of therapy to be effective, many repetitions are required — at least 400 in an hour-long session.
Results from three published pilot studies involving 36 children suggest that cerebral palsy patients can also benefit from robotic therapy. The studies indicate that robot-mediated therapy helped the children reduce impairment and improve the smoothness and speed of their reaching motions.
The researchers applied their work to stroke patients first because it is such a widespread problem — about 800,000 people suffer strokes in the United States every year. About 10,000 babies develop cerebral palsy in the United States each year, but there is more potential for long-term benefit for children with cerebral palsy.
"In the long run, people that have a stroke, if they are 70 or 80 years old, might stay with us for an average of 5 or 6 years after the stroke," says Krebs. "In the case of cerebral palsy, there is a whole life."
Most of the clinical work testing the device with cerebral palsy patients has been done at Blythedale Children's Hospital in Westchester County, N.Y., and Spaulding Rehabilitation Hospital in Boston. Other hospitals around the country and abroad are also testing various MIT-developed robotic therapy devices.
Krebs' team has focused first on robotic devices to help cerebral palsy patients with upper body therapy, but they have also initiated a project to design a pediatric robot for the ankle.
Among Krebs' and Hogan's collaborators on the cerebral palsy work are Dr. Mindy Aisen '76, former head of the Department of Veterans Affairs Office of Research and Development and presently the director and CEO of the Cerebral Palsy International Research Foundation (CPIRF); Dr. Joelle Mast, chief medical officer, and Barbara Ladenheim, director of research, of Blythedale Children's Hospital; and Fletcher McDowell, former CEO of the Burke Rehabilitation Hospital and a member of the CPIRF board of directors.
MIT's work on robotic therapy devices is funded by CPIRF and the Niarchos Foundation, the Department of Veterans Affairs, the New York State NYSCORE, and the National Center for Medical Rehabilitation Research of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Elizabeth Thomson | EurekAlert!
Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
20.10.2017 | Information Technology
20.10.2017 | Materials Sciences
20.10.2017 | Interdisciplinary Research